Provider Demographics
NPI:1164011391
Name:FRIZZELL COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:FRIZZELL COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:NICHOLE
Authorized Official - Last Name:FRIZZELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, CADC
Authorized Official - Phone:815-791-2295
Mailing Address - Street 1:310 E HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:PONTIAC
Mailing Address - State:IL
Mailing Address - Zip Code:61764-2033
Mailing Address - Country:US
Mailing Address - Phone:815-791-2295
Mailing Address - Fax:
Practice Address - Street 1:310 E HOWARD ST
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:IL
Practice Address - Zip Code:61764-2033
Practice Address - Country:US
Practice Address - Phone:815-791-2295
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-12
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty